J Korean Med Sci.
2025 Oct;40(39):e247. 10.3346/jkms.2025.40.e247.
Risk of Stroke in COVID-19 Survivors With Asthma: A Nationwide, Population-Based Cohort Study
- Affiliations
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- 1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
- 2Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, Korea
- 3Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Korea
- 4Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- 5Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Korea
- 6Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
- 7Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- 8Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- KMID: 2573183
- DOI: http://doi.org/10.3346/jkms.2025.40.e247
Abstract
- Background
The impact of coronavirus disease 2019 (COVID-19) on stroke risk in adult individuals with asthma post-recovery remains unclear.
Methods
Using a longitudinal retrospective cohort design based on the Korean National Health Insurance Service claims database, we analyzed stroke risk in two parts. Study 1 examined stroke risk in individuals with asthma according to COVID-19 severity, and Study 2 compared stroke risk between individuals with asthma (asthma cohort) and the general population without asthma (general population cohort), considering COVID-19 severity. Both studies used propensity score matching and Cox proportional hazards regression models for risk estimation.
Results
In Study 1, which evaluated stroke risk in the asthma cohort, the risk of stroke was significantly higher in the asthma cohort with severe COVID-19 compared to the asthma cohort without COVID-19 (adjusted hazard ratio [aHR], 1.88; 95% confidence interval [CI], 1.02–3.46). In Study 2, which evaluated stroke risk across six groups stratified by asthma status (asthma cohort and general population cohort) and COVID-19 severity (no, non-severe, and severe COVID-19), stroke risk was highest in the asthma cohort with severe COVID-19 (aHR, 3.42; 95% CI, 1.72–6.79, referring to the general population group without COVID-19), suggesting that severe COVID-19 has a more substantial effect on stroke risk in individuals with asthma.
Conclusion
This study highlights a significant association between severe COVID-19 and stroke occurrence in adults with asthma, emphasizing the need for ongoing stroke monitoring to improve long-term asthma outcomes during the COVID-19 endemic period.
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